Billing code PG14018 – Family Physician Urgent Telephone Advice from a Physician with Consultative Expertise – $40.00
The intent of this initiative is to improve management of the patient with acute needs, and reduce unnecessary ER or hospital admissions/transfers. This fee is billable when the patient’s condition requires urgent conferencing with a specialist or FP with specialty training within 2 hours of the request, and results in the development and implementation of a care plan within the next 24 hours to keep the patient stable in their current environment. This fee is not restricted by diagnosis or location of the patient, but by the urgency of the need for care. There is no minimum time requirement.
- Conversation must take place within two hours of the FP’s request and must be physician to physician. Not payable for written communication (i.e. fax, letter, email).
- Fee Includes:
- Discussion with the specialist of pertinent family/patient history, history of presenting complaint, and discussion of the patient’s condition and management after reviewing laboratory and other data where indicated.
- Developing, documenting and implementing a plan to manage the patient safely in their care setting.
- Communication of the plan to the patient or the patient’s representative.
- The care plan must be recorded in patient chart and must include patient identifiers, reason for the care plan, list of co-morbidities, safety risks, list of interventions, what referrals to be made, what follow-up has been arranged
- Not payable to the same patient on the same date of service as fee item PG14077.
- Not payable to physicians who are employed by, or who are under a contract to a facility, who would otherwise have provided the service as a requirement of their employment or contract with the facility; or physicians working under salary, service contract or sessional arrangement.
- Include start time in time fields when submitting claim.
- Not payable for situations where the primary purpose of the call is to:
- Book an appointment
- Arrange for transfer of care that occurs within 24 hours
- Arrange for an expedited consultation or procedure within 24 hours
- Arrange for laboratory or diagnostic investigations
- Convey the results of diagnostic investigations
- Arrange a hospital bed for the patient.
- Obtain non-urgent advice for patient management (i.e. not required within the next 24 hours).
- Limited to one claim per patient per physician per day.
- Out-of-Office Hours Premiums may not be claimed in addition.
- Maximum of 6 (six) services per patient, per practitioner, per calendar year.
- Payable in addition to a visit on the same date.
- Reciprocal billing for out-of-province (Yukon) patients requires: code for the province/territory of patient residence, PHN, name, sex, date of birth, and patient home address.
- For physicians enrolled in the LFP Payment Schedule conferencing, consulting, and meeting with other physicians and/or other health professionals for a specific patient(s) is an eligible Indirect Patient Care (98011) activity. Click here to review the most up to date payment schedule to ensure appropriate billing for time spent on a RACE call, or contact LFP.email@example.com.
- Read more about code PG14018
- For members of the Society of General Practitioners of BC: http://sgp.bc.ca/fee-category/conferencing-in-person-phone/
Billing code 19930 & 1102365 – WorkSafeBC RACE Line Billing Codes for Physicians and Nurse Practitioners
- The WorkSafeBC RACE Line is a WorkSafeBC service; only WorkSafeBC should be billed.
- Physicians and Nurse Practitioners can only bill if they have a patient with a claim or a patient for whom they will be reporting a claim.
- The following fee codes can be used: 19930 for Physicians in BC and 1102365 for Nurse Practitioners in BC.
- More information about WorkSafeBC billing codes are on WorkSafeBC website for Physician fee codes and Nurse Practitioner fee codes.
- For assistance with questions about Workplace Health and Safety, please contact WorkSafeBC Prevention Services at 604-276-3100 or toll-free at 1-888-621-7233 (1-888-621-SAFE)
- For questions about WorkSafeBC payment/billing, please call 604-276-3085 or Toll-free 1-888-422-2228
- For general WorkSafeBC information, please visit www.worksafebc.com
Note: For WorkSafeBC RACE calls, please use unique WorkSafeBC Fee Codes only